Last week’s biggest economic news was that median household income is up by a surprisingly strong 5.2%. A related economic indicator released the next day attracted less attention, but should raise just as many eyebrows: employer health premiums grew at a shockingly slow pace, only up 3% last year, according to the Kaiser Family Foundation’s annual survey. Healthcare is 18% of the U.S. gross domestic product, so unanticipated shifts in health spending have major repercussions.

Employers traditionally err on the side of caution and rein in wages when they are pessimistic about the trajectory of health costs. With household income up, we may be witnessing a new willingness to invest in wages, and thus a new level of employer confidence that health costs may be more under control. This is a breakthrough.

This confidence is rooted in a number of new strategies employers are adopting to streamline costs and improve care for their employees. Some are calibrating payment to the achievement of high-quality care. Others are paying for employees to seek out second opinions or explore a range of treatment options. Still others are offering on-site clinics, telemedicine and other innovative programs to increase preventive care. These steps are right on the money.

But the most dramatic cost control strategy is the one that sparks the most controversy: shifting to high-deductible health plans. As the Kaiser report shows, deductibles have increased substantially in the past decade. In 2006 just 4% of employers offered a high-deductible health plan, whereas 29% of employers now offer such a plan. Many employers help employees bear the brunt of those out-of-pocket costs by contributing to tax-advantaged health savings accounts, but overall, employees and families face a significantly heavier burden than in the past. And it’s not just employers: more than 90% of people enrolled in Obamacare exchange plans have a deductible of more than $3,000.

High-deductible health plans were first introduced by the Bush administration in 2003, over considerable opposition from Democrats who argued only healthy and/or rich people would benefit. But with the birth of the Affordable Care Act many of those same policymakers found themselves relying on high-deductible plans for the state exchanges. A high-deductible structure is often the only option for keeping premiums reasonable while meeting the new mandates for essential benefits.

High deductibles can do something else though: turn patients into shoppers. In theory, healthcare consumerism could drive a market for long-overdue improvements in a health system that continues to exhibit breathtaking problems in quality and cost-effectiveness. Unfortunately, it’s still only a theory. Consumers can barely find accurate prices, much less use the information with any sophistication. So the healthcare shopper is still the exception rather than the rule today.

Nonetheless, the idea that there’s a surge of discerning consumers on the horizon has driven significant, long-sought change in the healthcare system itself. Most health plans now offer decision-support tools with basic pricing guides and indicators of quality and safety. Hospitals are adopting core principles of the hospitality industry to attract and retain patients, and employ patient experience officers to monitor satisfaction in real time.

Indeed, slowly but surely, hospital leaders are recognizing that patients are on the hook for the cost of their care. In other words, the patient in the bed is a customer, and that changes everything.

Yet high-deductible health plans have a major problem: people can’t afford to pay the deductible. Does this mean they forgo needed care? Believe it or not, the jury is still out on that. There is some evidence that high deductibles discourage use of primary and preventive care–particularly for lower-income workers. On the other hand, there is some evidence high deductibles discourage use of unnecessary services, one of the most significant sources of healthcare waste, and a major hazard to patients.

Since high deductibles are the go-to strategy on both sides of the aisle, the challenge going forward is to explore new policy strategies to build on the strengths of the high-deductible movement while making the plans ultimately more affordable for consumers.

And that’s where health savings accounts (HSAs) come in. HSAs are currently subject to strict limits on the maximum amounts consumers or their employers can contribute. But those could be lifted higher. Employer contributions could also be exempted from consideration in calculating the so-called Cadillac tax. This would encourage employers to contribute more generously to the employee savings accounts while continuing to invest in lower-premium plans.

Perhaps more innovative options for coupling health savings accounts with high-deductible plans could be applied to health plans in the state exchanges as well. Could Obamacare subsidies include adding funds to health savings accounts? For those who don’t qualify for the subsidies, could part of the required premium be designated for a health savings account? This may attract younger people to enroll, since they might welcome the opportunity to save money tax-free, compounding interest over the decades ahead.

We will probably have to wait until November 9, but the time has come for innovative, constructive, bipartisan policies that move us forward in the right direction. The market appears to be headed there already.

I run an organization called The Leapfrog Group with a membership of highly impatient business leaders fed up with problems with injuries, accidents, and errors in hospitals. I can't stand the sight of blood but I've worked in healthcare over 20 years, including a rural hosp...